Long-term outcomes and prognostic factors in patients aged 70 years or older with early esophageal squamous cell carcinoma undergoing endoscopic submucosal dissection

Given the aging population, we aimed to evaluate the long-term outcomes and prognostic factors of overall survival (OS) in elderly patients who underwent endoscopic submucosal dissection (ESD) for early esophageal squamous cell carcinoma (ESCC). Between January 2000 and June 2022, we analyzed 103 patients aged 70 years or older who underwent ESD for ESCC. The long-term outcomes and prognoses were evaluated, and independent risk factors for OS were identified. The median age of the patients was 76.9 years (range 70–85 years). The 1-year, 3-year and 5-year OS rates in the curative resection group were 100%, 95.4% and 91.1%, respectively, while those in the noncurative resection group were 98.9%, 87.5% and 73.8%, respectively. The difference was statistically significant ( P = 0.029). The 1-year, 3-year and 5-year disease-specific survival (DSS) rates in the curative resection group were 100%, 100% and 96.4%, respectively, while the DSS rates in the noncurative resection group were 100%, 100% and 78.4%, respectively, with no statistical significance ( P = 0.090). Univariate analysis revealed that smoking, heavy alcohol consumption, cardiovascular disease, cerebrovascular disease, a history of cancer in other organs, a GNRI < 97.7, an NLR > 2.3, an ASA-PS, a CCI ≥ 3, the presence of LVI, and noncurative ESD were significantly associated with OS. Multivariate analysis revealed that a CCI ≥ 3 ( P = 0.001) and a GNRI < 97.7 ( P < 0.001) were independent risk factors for OS. The results revealed that a GNRI < 97.7 and a CCI ≥ 3 were significantly associated with poor prognosis in elderly patients undergoing ESD for early ESCC.